1). Clinicians should refer to an online information resource (such as http://www.hep-druginteractions.org) or seek expert opinion on possible PK interactions. BOC: may be considered on a case-by-case basis in virologically suppressed patients with no suspected drug resistance. Increased HIV viral load monitoring is required TVR: clinical and laboratory monitoring for hyperbilirubinaemia BOC: not recommended TVR: the dose should be increased to 1125 mg
tds (* PK study results reflect this) and total dose should not be split twice daily BOC: no dose adjustment required TVR: decrease not clinically significant, thus dosage adjustment is not required BOC: no dose adjustment required TVR: decrease not clinically significant, thus dosage adjustment check details is not required BOC: no dose adjustment required TVR: increased clinical and laboratory monitoring is recommended We recommend all patients have a baseline fibrosis stage assessment. We recommend all patients should be managed by a clinician experienced in the management of both HIV and hepatitis C or should be jointly managed by clinicians from HIV and hepatitis backgrounds. We recommend all patients with HCV/HIV infection should be assessed for suitability for treatment of hepatitis C. We recommend consideration for referral to liaison psychiatry services for patients with pre-existing mental health problems prior to initiation of therapy and for patients with
treatment-emergent psychiatric problems. We recommend
eltoprazine individuals with dependency on alcohol and/or injection drug use are referred to the respective community services Selleck C59 wnt before initiation of therapy to minimise non-adherence with treatment. We recommend patients with advanced cirrhosis, low platelet counts and low albumin should be treated in centres experienced in managing patients with advanced disease and potential complications. Proportion of patients diagnosed with HCV/HIV receiving a baseline fibrosis stage assessment In patients with chronic hepatitis C, the aim of anti-HCV treatment is to achieve clearance of the virus as measured by a negative HCV-PCR 24 weeks after completion of therapy (SVR: sustained virological response). The decisions on whether or not to commence therapy for HCV, what to start treatment with, and the duration of therapy, will depend upon several factors. These can be summarised as ‘patient’ factors (preference, risk of transmission and re-infection, adherence, age, and co-morbidities including potential for DDIs), ‘viral’ factors (genotype, HCV viral load and interferon responsiveness), ‘hepatic’ factors (degree of fibrosis and risk of decompensation) and ‘genetic’ factors (IL28B status). In addition, availability of research studies is an important consideration. The advent of DAAs has dramatically altered the outcome of treatment of hepatitis C in both monoinfected and coinfected patients.